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27 July 2012

IAC: A Supposedly Inclusive Event That Falls Short

Brazilian Protester

The massive International AIDS Conference winds down here in Washington DC. Bill Clinton will close the event this afternoon, a bookend to the opening speech from wife Hillary.

Little meaningful stories have emerged from this event. Treatment as prevention continues to be the mantra. Some, like Bill Gates, have added a bit of realism to the attempt to raise hope about the beginning of the end of AIDS by pointing out that the real end will not realized without a cure and a vaccine.

There is plenty of good news. Advances like Truvada that will prevent the spread of HIV between partners and low cost solutions such as voluntary medical male circumcision can reduce the likelihood of spreading HIV. All are exciting and can be combined to significantly reduce the chances of new infections, but the race to zero new infections is extremely challenging.

I noted that UNAIDS says global HIV/AIDS funding falls short by $7 billion each year. Yesterday, the Director of the WHO's HIV Department, Gottfried Hinschall, said that a further $4 billion is needed to meet the needs of marginalized groups, like men who have sex with men (MSM) and sex workers, each year.

The real story is that of the marginalized. The sex workers and drug users who shoulder the burden of HIV in many countries, but were unable to gain access to this conference due to US visa laws. Further, it is the very people who are in fact at greatest risk or are living with HIV that have been largely left out of the major panels and press conferences.

It took a march by Brazilian HIV activists into the press room located in the bottom of the convention center to finally give activists the opportunity to speak in front of the press. That is not to say all have been ingnored. The BBC reported on the problem's in Brazil yesterday morning. However, the very people who are affected by the discussions taking place in Washington DC are not sitting at table.

"Latin American is invisible in this conference because governments and donors think that the AIDS situation is solved in our countries," said one of the protesters yesterday. "Well, it is not."

One exception was yesterday's plenary that featured Hinschall alongside Uganda researcher and HIV rights activist Dr Paul Semugoma, researcher Cheryl Overs and Transgender community activist Debbie McMillian. It brought together the very people who are directly impacted by HIV/AIDS, who work with the populations the marginalized and have research and policy experience.

The panel members outlined the importance of reaching out to all people, especially the most vulnerable to infection, need to be included in the very development and implementation of programs aimed at reducing HIV infections. Dr Semugoma said that the international community can play a role in supporting MSM by working with the community rather than exerting direct pressure on governments.

"The way to to go forward is to teach. The way to go forward is to shame," said Dr Semugoma. "I am shaming my country. You can't start doing HIV prevention when you don't have good programs for sex workers and men who have sex with men; simply because you are feel too morally upright to support an HIV prevention program."

What is unfortunate is that examples like yesterday's plenary and the Brazilian activists have proven to be the exception rather than the rule at the IAC. The lively Global Village is meant to serve as a way to counterbalance the problem, but placing it in the netherworld of the basement (next to the media room) prevents a more natural opportunity or conversation with the big players who have their well organized space at the center's top floor with photo booths and frozen yogurt.

The message of the conference has been one of working together to turn the tide of AIDS towards a future where it does not exist. That may be possible, but the collaborative part is important and seemingly absent at IAC. Dr Semugoma summed it up well, "It is possible. We have the tools, but we can be shackled by our own ignorance."